of my engagement
as a model, and for other good and valuable consideration herein
as received, I hereby grant to (insert your name here)
his/her heirs, legal representatives and assigns, those for whom
is acting, and those acting with his/her authority, and permission, the
irrevocable and unrestricted right and permission to copyright, in
own name or otherwise, and use, re-use, publish, and re-publish
portraits or pictures of me or in which I may be included, in whole or
in part, or composite or distorted in character or form, without
as to changes or alterations, in conjunction with my own or a
name, or reproductions thereof in color or otherwise, made through any
medium at his/her studios or elsewhere, and in any and all media now or
hereafter known for illustration, promotion, art, editorial,
trade, or any other purpose whatsoever. I also consent to the use of
printed matter in conjunction therewith.
that I may have to inspect or approve the finished product or products
and the advertising copy or other matter that may be used in connection
therewith or the use to which it may be applied.
and agree to save harmless Photographer, his/her heirs, legal
and assigns, and all persons acting under his/her permission or
or those for whom he/she is acting, from any liability by virtue of any
blurring, distortion, alteration, optical illusion, or use in composite
form, whether intentional or otherwise, that may occur or be produced
the taking of said picture or in any subsequent processing thereof, as
well as any publication thereof, including without limitation any
for libel or invasion of privacy.
that I am
of full age and have the right to contract in my own name. I have read
the above authorization, release, and agreement, prior to its
and I am fully familiar with the contents thereof. This release shall
binding upon me and my heirs, legal representatives, and assigns.